| Mmg 1pc | |
|
31500 Telegraph Rd Suite 100 Bingham Farms MI 48025-4367 | |
| (248) 723-5880 | |
| (248) 723-5889 |
| Full Name | Mmg 1pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 31500 Telegraph Rd, Bingham Farms, Michigan |
| Authorized Official Name and Position | Geoffrey A Trivax (PRESIDENT) |
| Authorized Official Contact | 3135383099 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mmg 1pc 29992 Northwestern Hwy Farmington Hills MI 48334-3292 Ph: (248) 851-1430 | Mmg 1pc 31500 Telegraph Rd Suite 100 Bingham Farms MI 48025-4367 Ph: (248) 723-5880 |
| NPI Number | 1225063688 |
|---|---|
| Provider Enumeration Date | 07/12/2006 |
| Last Update Date | 09/20/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225063688 | NPI | - | NPPES |
| CG6180 | Other | MI | MEDICARE ID TYPE UNSPECIFIED |
| 110F301040 | Other | MI | BLUE SHIELD GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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